Provider Demographics
NPI:1831549757
Name:GILEAD MEDICAL ASSOCIATES
Entity type:Organization
Organization Name:GILEAD MEDICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THEODORE
Authorized Official - Middle Name:CHINATU
Authorized Official - Last Name:OSUALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-237-0897
Mailing Address - Street 1:9470 ANNAPOLIS RD
Mailing Address - Street 2:SUITE 117
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3025
Mailing Address - Country:US
Mailing Address - Phone:301-577-9111
Mailing Address - Fax:301-577-9199
Practice Address - Street 1:1818 NEW YORK AVE NE STE 213
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-1849
Practice Address - Country:US
Practice Address - Phone:301-577-9111
Practice Address - Fax:301-577-9199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-22
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDOO64126261QM0801X
2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty